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Chapter Five

Cardiovascular Health

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Cardiovascular Disease• Cardiovascular disease (CVD) is a disease of the

heart and blood vessels• Affects 80 million Americans• CVD is the leading cause of death in the United

States• CVD claims one life every 37 seconds—about 2400

Americans every day• Some CVD risk factors are controllable; others are

not• There are many things individuals can do to reduce

their risk of CVD2

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Risk Factors For Cardiovascular DiseaseMajor CVD Risk Factors That Can Be Changed

• Tobacco Use• High Blood Pressure

– Hypertension– See Table 11.1

• Unhealthy Cholesterol Levels– HDLs versus LDLs– See Table 11.2

• Physical Inactivity• Obesity• Diabetes

Major Risk Factors That Can Not Be Changed

• Heredity– Multiple genes contribute to

CVD risk

• Aging– CVD risk goes up with age

• Being Male– Men face a higher risk,

especially earlier in life

• Ethnicity– African Americans have higher

rates of hypertension and stroke

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Figure 11.1 Travels with Cholesterol

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Figure 11.2 Percentage of Adult Americans with Cardiovascular Disease

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• High Triglyceride Levels• Psychological and Social Factors such as:

• Stress• Chronic hostility and anger• Suppressing psychological distress• Depression and anxiety• Social isolation• Low socioeconomic status

• Alcohol and Drugs

Contributing Risk Factors That Contributing Risk Factors That Can Be ChangedCan Be Changed

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Possible Risk Factors Currently Being Studied• C-Reactive Protein

(CRP)– Inflammatory response

• Homocysteine– Amino acid

• Lipoprotein(a) or Lp(a)– Specific type of LDL– Strong genetic

component

• Infectious agents such as:

• Chlamydia pneumoniae

• Cytomegalovirus

• Helicobacter pylori

• Metabolic Syndrome (METX)– Insulin resistance

syndrome– See Table 11.3

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Major Forms ofCardiovascular Disease• Atherosclerosis

– Form of arteriosclerosis - thickening and hardening of the arteries

– Atherosclerosis – narrowed arteries by deposits of fat, cholesterol, and other substances

• Heart Disease and Heart Attacks– Myocardial infarction (MI)

– Coronary thrombosis

– Angina pectoris– Arrhythmia

– Sudden death

• Stroke• Congestive Heart

Failure8

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Atherosclerosis: The Process of Cardiovascular Disease

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Atherosclerosis• Atherosclerosis is thickening of the arteries by deposits of fat,

cholesterol, and other substances known as the term, ‘plaque’• The process begins when the lining of the cells become

damaged due to several factors such as• Smoking

• High blood pressure

• Deposits of LDL particles

• Blockage in the coronary arteries (coronary heart disease) can lead to a heart attack

• Blockage in the brain can result in a stroke

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Heart Disease and Heart Attacks

• A heart attack, or myocardial infarction, results when the coronary artery becomes blocked

• Angina pectoris is chest pain, a signal that the heart is not getting enough oxygen to supply its needs

• An arrhythmia is a condition when electrical impulses that control heartbeat become disrupted, resulting in an irregular pattern

• Sudden cardiac death or cardiac arrest is caused by arrhythmias and can result in death, if not treated immediately

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Figure 11.3 Blood Supply to the Heart

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Diagnosis and Treatment for Heart Disease• Diagnosis

– Exercise stress test– MRI, echocardiogram, angiogram

• Treatment– Lifestyle changes (diet and exercise)– Low-dose aspirin therapy– Prescription medications– Balloon angioplasty– Coronary bypass surgery

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Stroke• A stroke or cerebrovascular accident (CVA) occurs when

the blood supply to the brain is cut off• Types of strokes:

• Ischemic stroke = caused by a blood clot• Hemorrhagic stroke = caused by ruptured blood vessel• TIA – “warning stroke” or “mini stroke”

• Strokes may cause paralysis, walking disability, speech impairment, or memory loss

• Treatment may include clot-dissolving and antihypertensive drugs

• American Heart Association estimates the 705,000 Americans suffer a stroke each year

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Congestive Heart Failure

• Congestive heart failure is a condition resulting from the heart’s inability to pump out all the blood that returns to it

• Blood backs up in the veins leading to the heart, causing an accumulation of fluid in various parts of the body

• Caused by high blood pressure, heart attack, atherosclerosis, viral infections, rheumatic fever, and birth defects

• Pulmonary edema – Fluid collecting in the lungs that interferes with breathing when the individual is lying down

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Protecting Yourself Against Cardiovascular Disease• Eat heart-healthy

– Decreased fat and cholesterol intake

– Increased fiber intake– Decreased

sodium/increased potassium intake

– Moderate alcohol consumption

– DASH (dietary approach to stop hypertension

• Exercise regularly• Avoid tobacco• Know and manage your

blood pressure• Know and manage your

cholesterol Levels• Develop ways to handle

stress and anger

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Figure 11.4 Strategies for Reducing Your Risk of Cardiovascular Disease

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CHAPTER ELEVENCardiovascular Health